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<br />-" h,......"......_*'_"'~"...,.,...,.-,...,'.':~<._.". .."'"~.."'7,,....."1-T'"'""".....-. . <br /> <br />APPLICATION FOR PERMIT <br />CITY OF ZEPIIYRIIILLS <br />BUILDING DEPARTHEI1T <br /> <br />" <br /> <br />OWBER'S rwm W)<f't"v'L [Jv-/!-t:r'-r'......(d PRONE 7 'to . 7~()/ <br />OWBER'S ADDIlESS S-/ J I &1'11/ 0/& <br />JOB ADDRESS S-! J I 0--.-1 (( [J Iv' <br /> <br />LEGAL DESCRIPTION: LOT(S) / /, .2. (. -2, ( BLOCIL-SUBDIVISION <br /> <br />PARCEL LD.' <br /> <br />OO{O _/~$"o(J - aaJo <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPOSED:~ew Construction -...Addition ---..Alteration --Jlepair ~Install <br /> <br />_Sign <br /> <br />-.JIove <br /> <br />_Deaolish <br /> <br />PROPOSED USE: ~ingl.e Faaily <br /> <br />--lt/F _' of Units --lt/H <br /> <br />_~rcial <br /> <br />_Indust. _Swia. Pool _Other <br /> <br />---.:Restaurant &: Health Departaent Approval <br /> <br />DESCRIPTIOII OF WORK: <br /> <br />BUILDING SIZE: <br /> <br />p.... X 20 . <br /> <br />~uare Feet. 2 'I~ Height <br /> <br />RESIDEIITIAL: ATTACH (2) PLOT PLABS &: (2) SETS OF BUlLDIIIG PLAIIS &: (1) SET EBERGY FORKS. <br />COMMERCIAL: ATTACH (3) SETS OF BUILDING PLAIIS &: (1) SET EllERGY FORKS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />PERMITS REQUESTED <br /> <br />----.J)UlLDING <br /> <br />$. <br /> <br />2,~ <br /> <br />Valuation of Total Construction <br /> <br />RI.RCTRICAL <br /> <br />~ <br />, <br /> <br />AIIP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />~CAL <br /> <br />$. <br /> <br />Valuation of llechanica1 Installation <br /> <br />- <br />~UMBDfG GAS ROOFDIG <br />TYPE OF COIISmUCTIOII: _Block _FraIIe _Steel <br /> <br />SPECIALTY <br /> <br />Other <br /> <br />FDIISIIED FLOOR ELEVATIOIIS: <br /> <br />Fl. <br /> <br />IS PROJECT III FLOOD ZOO AREA? <br /> <br />YES NO <br /> <br />****************************************** <br /> <br />COIITRACTOR SECTION <br /> <br />BIJTI.DER <br /> <br />COIIPAIIY <br />. ~ State Cert. or Regist. . <br />G.J ~ A~ City License Registration . <br />*************....**..*..**.*************** <br /> <br />Signature <br /> <br />RI.RCTRICIAII COHPAIIY <br />State Cert. or Regist. . <br />SiDnAture City License Registration . <br />********************************.********* <br /> <br />PLUMBER COKPANY <br />State Cert. or It.eaist. . <br />Sigoature City License It.egistration . <br />****************************************** <br /> <br />IlECllABICAL COMPANY <br />State Cert. or Regist. . <br />Sigoature City License Registration . <br />*******.**********..********************** <br /> <br />OTRRR COHPAIIY <br />State Cert. or Regist. . <br />Sigoature City License Registration . <br />*.**********.*****.*****************.***** <br /> <br />APPLICATION APPROVED BY PERMIT OFFICER. <br />